HomeMy WebLinkAboutBUSINESS PLAN Hazardous. Materials/Hazardous :Waste Unified Permit--'
CONDITIONS OF.PERMI.TON-REVERSE SIDE · ~.
'* This ~ermit is iss~ for ~ follo~-~
~ H~ffious M~alsP~n
· JOES ~DIATOR SERVICE:-~ ~' D H~ousW~teOn~EeT~~'
LOCATION: 901 CALIFORNIA AVE . :.
: ..: ~.- : '..
OFFICE OF ENVIRONMENTAL SER VICES' ' '" ~ ' '
1715 Chester Ave., 3rd Floor : ,-~, Approved by:
Bakersfield, CA 93301 ':/ k.~p~auey.~ i . . ~ssu, nat~'
.... . Office of Ev~ervices
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: 'Ju~ 30.. 2003
SITE/FACILITY DIAGRAM
FORM 5
NORTH SCALE: BUSINESS NAME: FLOOR: OF
DATE:./ / FACILITY N~ME: UNIT ~''. OF
(CHECK ONE) SITE DIAGR.~%! FACILITY DIAGR.%M
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301
FACILITY NAME~_,4, J ~b.l~ I~'~](~Y ~SPECTION DATE I O-
ADDRESSfiOI ~o~,~-~ PHONENO. ~22 t~3
FACILITY CONTACT BUSINESS ID NO. 15-210-
~SPECTION TIME NLIMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
[~ Routine I~] Combined [~1 Joint Agency [~1 Multi-Agency ~ Complaint [~ Re-inspection
OPERATION C V · COMMENTS
Appr. opriate permit, on hand
Business plan contact information accurate
Visible address ..-- ,
Correct occupancy
Verification of inventory materials
Verification of quantities ,
Verification of location
Proper segregation of material
~ ,
Verification of MSDS availability ,
Verification of Hat Mat training
Emergency Verification of abatement supplies and procedures ~,,
procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party
White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector:
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301
FACILITY NAME
ADDRESS c-'lo~
FAClLITYCONTACT_0G-_fN~ i:.% &O t--d'~ BUSINESS IDNO. 15-210- O6OC/-6r 6"
INSPECTION TIME ~.O ~ i~ NUMBEROF EMPLOYEES 9__
Section 1: Business Plan and Inventory Program
[~lM~.outine [~l Combined [~l Joint Agency I~ Multi-Agency f~ Complaint 1~ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand ~L,-
Business plan contact information accurate V' (.Jl'~ dale. .... ~,e-D~..~7,
Visible
address
Correct occupancy b'
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled t,,"
Housekeeping 1,,"
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardou~w, aste on site?: [~Yes~ ~ No
Questions regarding this inspection? Please call us at (661) 326-3979 l s -n -s(§ite R~n,4il~'/~ Party
While- Env. Svcs. Yellow- S,a, ion Co~,y ~'i,~, - a,si,e~s Co~,y Inspector:
JOES RADIATOR SERVICE · ..... SiteID: 215-000-000466
J JAN
Manager : ~ ..... BusPhone: (805) 323-1263
Av~BYJ _ -- -- Map : 103 CommHaz : Moderate
Location:
901
CALIFORNIA
City : BAKERSFIELD ~ Grid: 3lA FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
JOSE M. EQEUDA / /
Business Phone: (805) 323-1263x Business Phone: ( ) - x
24-Hour Phone : (805) 325-5210x 24-Hour Phone : ( ) - x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire Press React ImmHlth DelHlth
Contact : Phone: ( ) - x
MailAddr: 901 CALIFORNIA AVE State: CA
City : BAKERSFIELD Zip : 93304
Owner JOSE (JOE) M. ESQUEDA Phone: (805) 325-5210x
Address : 11 PACIFIC ST State: CA
City : BAKERSFIELD Zip : 93305
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
----- Hazmat Inventory One Unified List
-- As Designated Order Ail Materials at Site,~
Hazmat Common Name... (SpooHazlEPA HazardsI Frm DailyMax IunitlMCP .
MURATIC ACID DH L 8 GAL Hi
SODIUM HYDROXIDE R DH S 125 LBS Mod
OXYGEN F P IH G 282 FT3 Low
ACETYLENE F P IH G 60 FT3 Hi
JOES RADIATOR SERVICE SiteID: 215-000-000466
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site
-- COMMON NAME / CHEMICAL NAME
MURATIC ACID Days On Site
365
Location within this Facility Unit Map: Grid:
SE CORNER ROOM #4 CAS#
7647-01-0
F STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE
Liquid /Pure Ii Ambient Ambient PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
GAL 8.00 GAL 8.00 GAL
HAZARDOUS COMPONENTS
%Wt. ~S CAS#
100.00 Muriatic Acid N 7647010
~IAZARD ASSESSMENTS
[ [, TSecret .No NoRS' BioHaz'' IN° Radioactive/AmountNo/ Curies EPA HazardsDH NFPA/// USDOT# MCPHi
~- Inventory Item 0002 Facility Unit: Fixed Containers on Site ~
~ CbMMON NAME / CHEMICAL NAME
SODIUM HYDROXIDE Days On Site
365
Location within this Facility Unit Map: Grid:
SW CORNER ROOM #4 CAS#
1310-73-2
STATE -- TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Solid Pure Ambient I Ambient DRUM/BARREL-NONMETAL
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
LBS 125.00 LBS I 50.00 LBS
HAZARDOUS COMPONENTS
%Wt.I oRS' CAS#
100.00 Sodium Hydroxide, Solution N 1310732
HAZARD ASSESSMENTS
TSecretl RSIBioHaz Radioactive/Amount EPA Hazards [ NFPA USDOT# [ MCP
No No No No/ Curies R DH / / / Mod
2 11/03/1998
JOES RADIATOR SERVICE SiteID: 215-000-000466
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
OXYGEN Days On Site
365
Location within this Facility Unit Map: Grid:
CENTER ROOM #4 CAS#
7782-44-7
F STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE
Gas Pure Ambient Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
FT3I 282.00 FT3 282.00 FT3
HAZARDOUS COMPONENTS
%Wt. ~S CAS#
100.00 Oxygen, Compressed N 7782447
T~ I HAZARD ASSESSMENTS
ecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No N No No/ Curies F P IH / / / Low
o
~ Inventory Item 0004 Facility Unit: Fixed Containers on Site
ACETYLENE Days On Site
365
Location within this Facility Unit Map: Grid:
NW ROOM #3 CAS#
74-86-2
Gas Pure Ambient Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
FT3I 60.00 FT3 60.00 FT3
HAZARDOUS COMPONENTS
%Wt. ~S CAS#
100.00 Acetylene N 74862
HAZARD ASSESSMENTS
TSecretNo NoRS [ BioHaz [I 'No Radioactive/AmountNo/ Curies FEPA Hazardsp IH NFPA/// USDOT# HiMCP
3 11/03/1998
JOES RADIATOR SERVICE SiteID: 215-000-000466
~ Inventory Item 0005 Facility Unit: Fixed Containers on Site
SODIUM HYDROXIDE Days On Site
365
Location within this Facility Unit Map: Grid:
REAR OF BLDG CAS#
1310-73-2
Liquid Pure Ambient Above Ambient METAL CONTAINR-NONDRUM
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
GALI 288.00 GAL 288.00 GAL
HAZARDOUS COMPONENTS
%Wt. RNo~ CAS#
100.00 Sodium Hydroxide, Solution 1310732
HAZARD ASSESSMENTS --
TSecretl ~S BioHaz Radioactive/Amount I EPA HazardsI NFPA USDOT# MCP
No N No No/ Curies R IH DH / / / Mod
-4- 11/03/1998
F JOES RADIATOR SERVICE SiteID: 215-000-000466
Fast Format
= Notif./Evacuation/Medical Overall Site
--Agency Notification 01/07/1990
CALL 911
~ Employee Notif./Evacuation 01/07/1990
THIS IS A TWO PERSON FACILITY. WE WORK SIDE BY SIDE ALL DAY LONG.
THE FACILITY HAS 2 LARGE DOORS (FRONT & BACK) OPEN ALL DAY LONG.
WE CAN EXIT THROUGH THE FRONT OR BACK & CALL 911.
~ Public Notif./Evacuation 01/07/1990
USE COMMON SENSE ENTRANCES AND EXITS ARE CLEARLY NOTICEABLE. A) FIRST AID KITS CLEARLY VISIBLE
B) EXTINGUISHERS CLEARLY VISIBLE
C) ASHTRAYS ARE CLEARLY VISIBLE
D) WASTE RECEPTICLES CLEARLY VISIBLE
Emergency Medical Plan 01/07/1990
USE COMMON SENSE, IF NECESSARY CALL 911 & CITY FIRE DEPT.
MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371
UP TO DATE FIRST AID KITS ARE AVAILABLE.
5 11/03/1998
F JOES RADIATOR SERVICE SiteID: 215-000-000466
Fast Format
~Mitigation/Prevent/Abatemt Overall Site
--Release Prevention 08/06/1992
THE ONLY REAL HAZARDOUS MATERIAL THAT WE USE IS MURATIC ACID. WE
HANDLE IT ONE GALLON AT A TIME.
COMPRESSED GAS CYLINDERS CHAINED & USE PROPER VALVES AND FITTINGS
CIP TANK COVERED
SAFETY GLOVES ARE PRESENT WHEN USING CLEANING SOLUTIONS.
-- Release Containment 08/06/1992
USE DRY ABSORBANT TO CONTAIN
-- Clean Up 08/06/1992
IF A SPILL OCCURS WE'LL WASH IT WITH WATER.
MINOR OIL SPILLS ARE CLEANED WITH PROPER DRY ABSORBANTS, DISPOSAL IN
PROPER MANNER.
Activation
I Other Resource
6 11/03/1998
f JOES RADIATOR SERVICE SiteID: 215-000-000466
Fast Format
~ Site Emergency Factors Overall Site
Special Hazards
--Utility Shut-Offs 04/14/1992
A) GAS - EAST SIDE OF BUILDING
B) ELECTRICAL - INSIDE BUILDING
C) WATER - SOUTH SIDE OF BUILDING
D) SPECIAL - NONE
E) LOCK BOX - NO
Fire Protec./Avail. Water 04/14/1992
,PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER AND TWO WATER HOSES
FIRE HYDR3tNT - NORTHEAST CORNER OF PROPERTY.
Building Occupancy Level
7 11/03/1998
JOES RADIATOR SERVICE SiteID: 215-000-000466
Fast Format
TraininH Overall Site
~ Employee TraininH 08/06/1992
THERE IS 1 EMPLOYEE AT THIS FACILITY
WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE
OWNER AND CO-WORKER HAVE VERBALLY REVIEWED HAZARDOUS CHEMICAL USAGE.
BOTH PARTIES UNDERSTAND HOW TO PROPERLY USE AND DISPOSE OF HAZARDOUS
MATERIALS.
MATERIALS SAFETY DATA SHEETS AND BOOKLETS ARE WITHIN ACCESS TO ANY
EMPLOYEE IN BUILDING.
A) SAFETY LABELS ARE PRESENT ON ALL CHEMICAL CONTAINERS
-- PaHe 2
-- Held for Future Use
Held for Future Use I
8 11/03/1998
.Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
............. ~,~¢~,~,,~,~;~,,~,~,,,,~, ........... This permit is issued for the following:
,~,,?i'i'::'[: ~,i*:: :?~:?:;ii iiii;. :~.ii!}?.!iiii~. }iiii~i ii?. ii:~,:;,ila;;ilU~e[ground Storage of Hazardous Materials
PERMIT ID# 015-0214)00466 ?i[¢i!t ~i ,ii:iI i!i [ ii~*~ ~!?~!!!~:!!![!~[~.~.:~!!!!!)~;!!~[!~!![!!!~!i}i~}[~!!~[!~ki=:}~gement Program
LOCATION 901 CALl F O RN ~:::.7'~:}: }J~!~?.?:?~' B~'~$~.i~LD CA
... ~.:z::.'"..,. ~ .-' ¢" '. '~..:!~? .' ~ ' .' , · ,: ' : ~ ' r ~ ]~ ~ 7 ~'-..
B~er,field Fke D~ment Approv~ by:
O~CE OFE~RO~AL 5~ ~CES ~ ~ph
1715 Chewer Ave., 3rd Floor Office of ~m~l S~i~
B~emfiel~ CA 93301
Voice (805),2~70 Expiration Date: ~Un~ ~0~ ~000
F~ (805) 326~576
)4/14/92 JOES RADIATOR SERVICE 215-000-000 Page
Overall Site with 1 Fac. Unit U AUG 5 1992
General Information By ,
Location: 901 CALIFORNIA AV Map: 103 Hazard: Moderate
Community: BAKERSFIELD STATION 06 Grid: 3lA F/U: 1AOV: 0.0
Contact Name Title Business Phone 24-.Hour Phone-
JOSE M. EQEUDA (805) 323-1263 x (805) 325-5210
( ) - x ( ) -
Administrative Data
Mail Addrs: 901 CALIFORNIA AV D&B Number:
City: BAKERSFIELD State:· CA Zip: 93304-
Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code:
Owner: JOSE (JOE) M. ESQUEDA Phone: (~)3a~=~
Address: 11 PACIFIC ST State: CA
City: BAKERSFIELD Zip: 93305-
Summary
reviewed the attached h.azardous mat~ria~ manage-
ment plan for ~'"; and
any correction$Cons~itute a complete and correc~ man-
agement plan for my facility.
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 2
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order ·
02-001 MURATIC ACID Liquid 8 High
~.Delay Hlth GAL
CAS #: 7647-01-0 Trade Secret: No
Form: Liquid Type: Pure Days: 365 Use: CLEANING
Daily Max GAL8 I Daily Average8.00GAL I Annual Amount48.00GAL --
Location
Storage Press T Temp
PLASTIC CONTAINER IAmbient~AmbientlSE CORNER ROOM #4
-- Conc Components MCP List
100.0% IMuriatic Acid IHigh '1
02-002 SODIUM HYDROXIDE Solid 125' Moderate
~ Reactive, Delay Hlth LBS
CAS #: 1310-73-2 Trade Secret: No
Form: Solid Type: Pure Days: 365 Use: CLEANING
Daily Max LBSI Daily Average LBS I Annual Amount 250.00 LBS --
125 ~ 50.00
Storage~~Press T Temp Location
DRUM/BARREL-NONMETAL IAmbient~ambientlSW CORNER~ROOM #4
-- Conc Components MCP List
100.0% ISodium Hydroxide, Solution IModeratel
02-003 OXYGEN Gas 282 Low
· Fire, Pressure, Immed Hlth FT3
CAS #: 7782-44-7 Trade Secret: No
Form: Gas Type: Pure Days: 365. Use: WELDING SOLDERING
Daily Max FT3 Daily Average FT3 I Annual Amount FT3 --
282 I 282.00! 6,768.00
Storage~~Press T Temp Location'
PORT. PRESS. CYLINDER Iambient~AmbientlCENTER ROOM #4
- Conc Components MCP List
100.0% IOxygen, Compressed ILow I
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 3
02 - Fixed Containers on Site
Hazmat .Inventory Detail in Reference Number Order
02-004 ACETYLENE Gas 60 High
· Fire, Pressure, Immed Hlth FT3
CAS #: 74-86-2 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING
Daily Max FT3I Daily Average FT3 I Annual Amount FT3
60 ~ 60.00 120.00
Storage Press T Temp~ Location
PORT. PRESS..CYLINDER Ambient~AmbientlNW ROOM #3
-- Conc Components ~ MCP List
100.0% IAcetylene IHigh I
02-005 SODIUM HYDROXIDE Liquid 288 Moderate
· Reactive, Immed Hlth, Delay Hlth GAL
CAS #: 1310-73-2 Trade Secret: No
Form: Liquid Type: Pure Days: 365 Use: CLEANING
Daily Max GAL288I~ Daily Average288.00GAL --~----.Annual Amount288.00.GAL--
Storage Press T Temp~ Location
METAL CONTAINR-NONDRUM Ambient~Above IREAR OF BLDG
-- Conc Components MCP ---/List
100.0% ISodium Hydroxide, Solution IModeratel
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
THIS IS A TWO PERSON FACILITY. WE WORK SIDE BY SIDE ALL DAY LONG.
THE FACILITY HAS 2 LARGE DOORS (FRONT & BACK) OPEN ALL DAY LONG.
WE CAN EXIT THROUGH THE FRONT OR BACK & CALL 911.
<3> Public Notif./Evacuation
USE COMMON SENSE ENTRANCES AND EXITS ARE CLEARLY NOTICEABLE. A) FIRST AID~KITS CLEARLY VISIBLE
B) EXTINGUISHERS CLEARLY VISIBLE
C) ASHTRAYS ARE CLEARLY VISIBLE
D) WASTE RECEPTICLES CLEARLY VISIBLE
<4> Emergency Medical Plan
USE COMMON SENSE, IF NECESSARY CALL 911 & CITY FIRE DEPT.
MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371
UP TO DATE FIRST AID KITS' ARE AVAILABLE.
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 5
00 - Overall Site ~
<E> Mitigation/Prevent/Abatemt
<1> ReleaSe Prevention
THE ONLY REAL HAZARDOUS MATERIAL THAT WE USE IS MURATIC ACID. WE
HANDLE IT.ONE GALLON AT A TIME.
COMPRESSED GAS CYLINDERS'CHAINED & USE PROPER VALVES AND FITTINGS
CIP TANK COVERED
SAFETY GLOVES ARE PRESENT WHEN USING CLEANING SOLUTIONS.
<2> Release Containment
<3> Clean Up
IF A SPILL OCCURS WE'LL WASH IT WITH WATER.
MINOR OIL SPILLS ARE CLEANED WITH PROPER. DRY ABSORBANTS, DISPOSAL IN
PROPER MANNER.
<4> Other Resource Activation
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - EAST SIDE OF BUILDING
B) ELECTRICAL - INSIDE BUILDING
C) WATER - SOUTH SIDE OF BUILDING
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
3A SEC 4) FIRE EXTINGUISHER AND TWO WATER HOSES
FOR FIRE PROTECTION.
3A SEC 5) FIRE HYDRANT LOCATED ON THE NORTHEAST
CORNER OF PROPERTY.
<4> Building Occupancy.Level
04/14/92 JOES RADIATOR SERVICE 215-000-000466 Page 7
00 - Overall Site
<G> Training
<1> Page 1
THERE ARE ? EMPLOYEES AT THIS FACILITY. ~O
WE.HAVE MATERIALS SAFETY DATA SHEETS ON FILE? ~
OWNER AND CO-WORKER HAVE VERBALLY REVIEWED HAZARDOUS CHEMICAL USAGE.
BOTH PARTIES UNDERSTAND HOW TO PROPERLY. USE AND DISPOSE OF HAZARDOUS
MATERIALS.
MATERIALS SAFETY DATA SHEETS AND BOOKLETS ARE WITHIN ACCESS TO ANY
EMPLOYEE IN BUILDING.
A) SAFETY LABELS ARE PRESENT ON ALL CHEMICAL CONTAINERS
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for Future Use
CITY of BAKERSFIELD
(t~'~e or prin~ name)
RECEIVED
Do hereby c~-ti~-- '
~= ~? that I' have reviewem the
FEB
HAT_. MAT. DIV.
attached Hazardous Haterials business plan
for 00,,~ .
(name of business)
and that it along with the attached additions
or corrections constitute a complete and correct
Business Plan for m,v facilit.v.
-s2~na~t[be ~ ~ ~ -c[~te '
BUSINESS NflI~E JOES ATOR SERVICE ID Zl,.S-GGO-(~4G$
LOCATION 901 CALIFORNIA AV HIGH HAZARD RATING
1. OVERVIEW
LAST CHANGE 04/Zl/88 BY ESTER
JURIS CODE ZtS-00G JURIS BAKERSFIELD STATION 08
MEP PAGE 103 GRIO 3lA FRCILITY UNITS 1 HAZARD RATING 3
RESPONSE SUMMARY
2A SEC 4) NO PRIVATE RESPONSE TEAM
EMERGENCY CONTACTS 2A SEC 2)
JOSE M. EQEUDA JR. 3Z3-1ZG3 OR 32S-5Z10
UTILITY SHUTOFFS 2A SEC 3)
A) GAS - ERST S10E .OF BLDG B) ELECTRICAt. - INSIOE BLDG
C) WATER - S SIDE OF 8LDG D) SPECIAL - NONE
E) LOCK BOX - NO-
Z, NOTIFICATION / PUBLIC EVACUATION
LAST CHANGE / / BY
< NO INFORMATION RECORDED FOR THIS SECTION >
PAGE 1 IZ/Z3/88 1S:S6
MATERIAL SAFETY DATA SYSTEMS, INC. (DOS)B48-6800
BUSINESS NAME JOES RADIATOR SERVICE ID NUMBER Z15--~00-000466
LOCATION 901 CALIFORNIA AV HIGH HAZARD R~TING 3
3. HRZ MAT TRAINING SUMM~RY
L~ST CHANGE / / BY
< NO. INFORMATION RECORDED FOR THIS SECTION >
LOCAL EMERGENCY MEDICAL ASSISTANCE
LAST CHANGE 04/21/88 BY ESTER
SEC 5) USECOMMON SENSE, IF NECESSARY CALL 9ll & CITY FIRE DEPT.
MERCY HOSPITAL - ZZ1S TRUXTUN AVE - 3Z7-3371
PAGE 2 12.123188
MATERIAL SAFETY .DATA SYSTEMS, INC. (80S) B48-B80~
BUSINESS NAME JOES ATOR SERVICE ID N R Z1S-OOO-OOO4GG
LOCATION 901 CALIFORNIA AV HIGH HAZRRD RRI'ING 3
FACILITY UNIT 01
A, OVERALL HAZARDOUS MATERIALS INVENTORY
LAST CHANGE 04/Zt/88 BY ESTER
ID TYPE NAME M~X AMT UNIT HAZARD
LOCATION CONTAINMENT USE
1 PURE MURATIC ACID 8 G~L. HIGH
SE CORNER ROOM ~4 PLASTIC CONTAINER£S] CLEANING
IO PERCENT COMPONENTS HAZARD LIST
1078,0Z 100.0 MURIATIC ACID HIGH
Z PURE SODIUM HYDROXIDE 1~5 LBS HIGH
SW CORNER ROOM ~4 DRUMS OR BRRR NON MET, CLEANING
ID PERCENT COMPONENTS HAZARD LIST
t560.00 100.0 SODIUM HYDROXIOE, SOLUTION HIGH
3 PURE OXYGEN ZB2 FT3 HIGH
CENTER ROOM ~t4. PORTABLE PRESS. CYLo WELOING/SOLOERING
ID PERCENT COMPONENTS HAZARD LIST
23S~.00 ~00.0 OXYGEN, COMPRESSED HIGH
4 PURE 8CETYLENE 60 FT3 EXTREME
NW ROOM ~3 PORTABLE PRESS. CYL. WEt. DING/SOLDERING
ID PERCENT COMPONENTS HAZARD LIST
1~41.00 100,0 ACETYLENE EXTREME
5 PURE SODIUM HYDROXIDE ZBB GAL HIGH
SOUTH OF SHOP METAL CONTAINERS CLEANING
ID PERCENT COMPONENTS HAZARD LIST
~560,00 100.0 SODIUM HYOROXIOE, SOLUTION HIGH
PAGE 3 IZ/Z3/@B 1B:SG
MATERIAL SRFETY DATA SYSTEMS, INC. (805) B48-G800
BUSINESS NAME JOES RADIATOR SERVICE ID NUMBER ZtS-~O-OOO4GS
LOCATION 901 CALIFORNI~ AV HIGH HAZARD RATING 3
B. FIRE PROTECTION / WATER SUPPLIES
LAST CHANGE 04/Z1/88 BY ESTER
3A SEC 4) FIRE EXTINGUISHER AND TWO WATER HOSES FOR FIRE PROTECTION.
SEC S) FIRE HYDRANT LOCATED ON THE NORTHEAST CORNER OF PROPERTY.
O. EMPLOYEE NOTIFICATION / EVACUA'rlON
LAST CHANGE 04/Z1/88 BY ESTER
SEC 2) THIS IS A TWO PERSON FRCI[.ITY. WE' WORK S10E BY SIDE RLL DRY LONG.
'THE FACILITY HAS Z t, ARGE DOORS (FRONT & BACK) OPEN ALL DAY LONG.
WE CAN EXIT THROUGH THE FRONT OR BACK & CALL 911.
PAGE 4 IZ/Z~/88 1S:SG
MATERIAl_ SAFETY DATA SYSTEMS, INC. (805) G48-G800
BUSINESS NAME JOES ATOR SERVICE ID Z1S-<~O0-OOO48G
LOCATION 90! CRI_IFORNIR RV HIGH HRZRRD RATING 3
E. MITIGATION / PREVENTION / ABATEMENT
LAST CHANGE 04/Z1/88 BY ESTER
SEC 1) THE ONLY REAL HAZARDOUS MATERIAL THAT WE USE IS MURAT'IC ACID. WE
HANOLE IT ONE GALLON AT A TIME. IF A SPILL SHOULO OCCUR WE'LL WASH
IT WITH WATER. COMPRESSED GAS CYLINDERS CHAINED & USE PROPER VALVES
& FITTINGS. CIP TANK COVERED.
PAGE S lZ/Z3/88 lB:SM
MATERIAL SAFETY OflTfl SYSTEMS, INC, (805) G48-G8~)0
CIT:Y of BAKERSFIELD
NON--TRADE SECRETS
' Pege .... of ....
C~e C~e Mt Mt Est Units m Site lp ~ la ~ St~ tn FKtltty
(C~k all t~t I~ly) ~?
(C~k ell t~t apply)
(C~k ~ll t~t ~pply)
NNlth of P~lu~ NMIth
3q
M~lth - of erasure Health
at 13 ~ iC.l.S. ~e
~(erttficatf~ (Reed and sJ~ after colpJetJng a/J sections/
for,~r~aifling t~ inf~ttffi. I ~iieve t~t t~ su~itt~ info~ti~ iS t~, accurate, and c~plete. ~ A A
.'" ' BAKERSFIELD CITY FIRE DEPARTMENT
> 2130 "G" STREET
(805) 326-3979
OFFICIAL USE ONLY
BUSINESS NAME
HAZARDOUS MATERI ALS
BUSINESS PLAN AS A WHOLE
: FORM 2A
INSTRUCTIONS:
1. To avoid further action, return this form by
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
SECTION 1: BUSINESS IDENTIFICATION DATA
A. BUSINESS NAME: ~el3
B. LOCATION / STREET ADDRESS:
C I TY: ~/~., ./~ ~ ,~/~/d/ .~. ZIP:
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or threatened release of a
hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. Thi§ wi].l notify
your local fire department and the State Office of Emergency Services as req~lired by
law.
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY:
NAME AND TI_~E DURING BUS. HRS. AFTER BUS. HRS.
B. Ph~ Ph~
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
E. LOCK BOX: YES / N~ IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO
FLOOR PLANS? YES / NO KEYS? YES / NO
- 2A -
SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE
.
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
SECTION 6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INITIAL' REFRESHER
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
MATERIALS:.... .................................... ~ NO YES NO
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: ..... ~ .................... NO .YES NO "
C. PROPER USE OF SAFETY EQUIPMENT:... ................ N0 'YES NO
D. EMERGENCY EVACUATION PROCEDURES:.., ............... ~ YES NO
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... N~ YES NO
SECTION ?: .AZA OUS
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUN~F A
SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ('YES,/ NO
I, ~O. //~, /'3~,~c,~/ , certify that the above information is accurate.
I f-fdGrsGana' that-t~d info~mation will be used to fulfill my firm's obligations under
thy new CaliforniaL~ealth and Safety code on Hazardous Materials (Div. 20 Chapter 6.'95
Sec. 25500 Et Al..) and that inaccurate information constitutes perjury.
BAKERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET
BAKERSFIELD, CA 93301
OFFICIAL USE ONLY
BUSINESS NAME: ~'~
BUSI NESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS · :'~.-
1. To avoid further action, this form must be returned by:
2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.
3. Answer the questions below for THE FACILITY UNIT LISTED BELOW
4. Be as BRIEF and CONCISE as .possible. .: .. ' '' "~' '.
FACILITY UNIT# ~ ~ FACILITY UNIT NAME: .~.--
SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES
SECTION 2: NOTIFICATION .%YD EVACUATION PROCED.URES AT THIS 5~'IT ONLY
SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY
A. Does this Facility Unit contain Hazardous Materials? ...... Y~ NO
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (~vhite form ~4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade
secret form· List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION
*SECTION 8: L~CATION 0F WATER SUPPLY FOR USE BY E~RGENCY RES~0N~ERS
SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS b~."IT ONLY.
A. NAT. GAS/PROPANE':
B. ELECTRICAL:
7- ' /.%. Sro v
C. WATER:
D SPEC!.7
· C' YES '/NO} IF YES LOCATION:
E LO..R BOX: ...' ,
YES, STTE.PLANS? YES / NO .tSDgs., YES 5:0
FLOOR Pr. ANS? YES /' NO ~EYS? YES ." NO
- SB -
I D # 30~/3 FORM 4A-1 Page of
NON--TRADE SECRETS
HAZARDOUS MATERI ALS I NVENTORY
PHONE ~~-5'-'~'~'1'3~- ' ' ' ' PHONE *: OFFICIAL USE CFIRS CODE
........ ONLY
I 2 3 4 5 6 7 8 9 10
TYPE. MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE OUID~
EMERGENCY CONTACT: - 'TITLE: ~- PHONE-~US HdURS:
AFTER BUS HRS: Oa
~'HEBGENCY CONTACT: TITLE~: .. PBONE ~ BUS HOURS:
~RINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: